The dangers of hurling—genital injuries arising in the modern game

Abstract

Objective

To assess the proportion of penoscrotal injuries arising from the sport of hurling and to assess work-up and management of each injury.

Methods

Using Hospital In-Patient Enquiry data, all penoscrotal injuries occurring over a 10-year period between 2007 and 2017 were identified and assessed. Chart review, imaging reports, operative notes and discharge summaries were used to identify the aetiology of each injury and those occurring due to hurling were selected for analysis. Investigations and management of each case were reviewed.

Results

Seventy patients presented to our institution over a 10-year period with penoscrotal injuries and, of these, ten patients (14%) presented with injuries arising due to blunt scrotal trauma whilst playing hurling. The average age of these patients was 24.3 years, and the right testicle was injured six times, compared with the left testicle twice and isolated scrotal injuries twice also. One hundred percent of patients underwent diagnostic ultrasonography with Doppler flow assessment with 90% (n = 9) having positive findings. Three patients (33%) required operative management with only one patient (10%) requiring an orchidectomy. There were no delayed or interval procedures.

Conclusion

Hurling is a physical sport with a notable proportion of blunt scrotal trauma arising due to the sport. Prompt physical examination and diagnostic ultrasonography are essential in investigations of injuries, and surgical exploration should be considered in all cases with concerns of testicular survival. Groin protection should be recommended to all players and in particular to those at high risk such as single testis or prior injury.